[Congressional Record Volume 148, Number 96 (Tuesday, July 16, 2002)]
[Senate]
[Pages S6815-S6816]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
14TH INTERNATIONAL CONFERENCE ON AIDS
Mr. DURBIN. Madam President, last Friday, July 12, the 14th
International Conference on AIDS closed in Barcelona, Spain. This
year's theme was ``Knowledge and Commitment for Action.''
More than 14,000 doctors, activists, and government officials
gathered in Barcelona for the largest AIDS conference ever.
At the last conference, hosted in Durban, South Africa, in the year
2000, the concluding plan, by all the nations that assembled, was to
take action on the following items: To spread the use of condoms as a
means of avoiding infection; to curb mother-to-child transmission of
AIDS and HIV; to empower women to choose their relationships and method
of contraception freely; and, finally, to educate people about the
risks.
The last 2 years have shown that all four of these activities can be
done successfully.
Another success achieved in the past 2 years is the focus shift to
providing treatment for all. This has been a result of lower drug costs
and the realization that people will not get tested unless there is
hope of treatment.
The opening session featured the Barcelona Declaration, which called
for action on the following goals by the year 2004: Secure a donation
of $10 billion per year for Global AIDS--$10 billion--provide 2 million
people in the developing world with antiretroviral treatment; third,
provide affordable drug treatment in the developed world and universal
access to generic brand drugs in the developing world; and fourth,
develop a new global partnership between government and nongovernment
organizations, recognizing the crucial roles that NGOs play in the
fight against AIDS.
The Barcelona conference has brought a great deal of attention to
HIV/AIDS. Newspapers daily provide America with devastating facts.
UNAIDS warns that the AIDS epidemic is just starting. An estimated 5
million new HIV infections occurred worldwide during 2001. That is
about 15,000 infections every single day. More than 95 percent of these
occur in developing countries. In 2001, 5 infections each minute
occurred in young people age 15 to 24, approximately 6,000 young people
in total. Worldwide, 13.4 million children have lost at least 1 parent
to AIDS. That number is expected to grow to more than 25 million by the
year 2010.
We tend to view AIDS and its growth as a Third World problem. We hear
the statistics: 40 million infected people in sub-Saharan Africa; 15
million AIDS orphans or more in sub-Saharan Africa; projections by the
World Bank that there will be over 20 million infected people in India
alone in the next 5 to 10 years; all of the talk about China and
Russia.
Never should we overlook the problem in the United States. AIDS is
still a problem; HIV infection is a reality. It is growing particularly
among the African-American population in America. It is growing
particularly among heterosexuals and among women. This is a problem we
have not conquered. In fact, we have not confronted it honestly in the
United States for too long a period of time.
UNAIDS has just issued a report on the situation in China. The report
is called ``China's Titanic Peril'' because the U.N. agency said, if
China doesn't act now, this boat will sink. The Chinese Government
estimates 850,000 are infected. The U.N. report indicates the Chinese
Government lacks political commitment and thus far has not provided
sufficient resources to deal with it. Seventeen percent of the people
in China have never heard of the disease. China, India, and Indonesia
are on the brink of outbreaks that could dwarf the current epidemic.
AIDS is the leading cause of death in sub-Saharan Africa. More than
28 million Africans are infected with it. HIV/AIDS weakens economic and
political stability, national security, and agricultural output, all
necessary for continued development.
The cost of AIDS rises each minute that the epidemic grows. Without a
drastic change in the global approach to the HIV/AIDS epidemic, it is
expected that an additional 45 million people will be living with AIDS
by 2010. From the facts reported in the daily newspapers, it is clear
that current spending levels are grievously insufficient to address the
global epidemic.
In 1993, experts asked the world for $2 billion annually to slow the
spread and to save $900 billion in associated costs. Only recently, the
level of global spending has climbed to $2.8 billion. Think of that, a
9-year period of time when we did not respond to this epidemic as it
spun out of control. This is well below the actual need today of $10
billion every year to fight this epidemic that is circling the globe.
A World Health Organization mathematical model estimates that only $9
billion can be usefully spent per year: $4.8 billion on prevention,
$4.2 billion on treatment. This number assumes the medical
infrastructures in developing countries will remain at current
capacities. Jeffrey Sachs, a well-known development economist based at
Columbia University in New York, suggests that investing in
infrastructures would raise the yearly cost to about $15 billion.
I have been to some of these countries suffering with AIDS. Many of
my colleagues have. You see that the medical infrastructure is
virtually primitive. Not only do they not have clinics, they don't have
water that is safe to drink. Imagine trying to treat an epidemic under
those conditions. An investment in the public health infrastructures of
these countries can mean we could put money into stopping and slowing
this epidemic.
The United States spends more than $10 billion domestically to fight
the disease, but we contribute only $1.1 billion to fight AIDS abroad.
A few weeks ago, I brought an amendment to the floor asking that we
make a commitment on an emergency basis to put $500 million more into
fighting the AIDS epidemic. I am sorry to report my colleagues would
not support me on that amendment. It is unfortunate. I believe, sadly,
that in years to come we will look back on this as a missed opportunity
to do something about an epidemic that will literally affect the lives
of all of our children and grandchildren and affect the stability of
the world.
What are the contributing causes to the global epidemic? No. 1 is
lack of education. Eighty percent of those most at risk receive no
information or any help with prevention. Just a few years back, 10 or
12 years ago, 30 percent of the pregnant women in Uganda were HIV
positive. That number is now down to 11 percent. Was there a massive
infusion of money into Uganda? There was, a selective infusion of money
into public education. It worked. They preached ABC, which is very
basic: Abstinence, which is the first advice to be given; make certain
that if you are going to be sexually active, you are monogamous; and
third, make certain you rely on condoms for protection if you don't
accept the other two as a premise for your lifestyle. It is very
fundamental, but it worked. It dramatically reduced the HIV infection
rate among those who were pregnant.
We need programs that are going to change the habits of people. We
have to understand poverty creates desperation. There is something we
have to
[[Page S6816]]
understand, which the Presiding Officer made a point of in the city of
Chicago many years ago after she had returned from a trip to South
Asia--I heard her speech; I remember it well--in which she said, the
biggest single indicator of the likelihood of progress in a developing
nation is the way they treat their women. If women are treated with
respect, if they are given a voice in the society, if they can help
decide their fate, you will have a more progressive society; you will
find a country able to respond to many crises, not just the health
crisis.
We in the United States have to understand that though we don't lead
the world in foreign aid, per capita, we certainly want to make certain
that our investment in foreign aid focuses on improving the role and
voice of women in developing countries. Women who are not treated as
slaves or chattel can make life decisions that will save their lives,
enrich their children's lives, and give them a marital situation with
hope instead of despair. That should be part of our approach in dealing
with AIDS as well.
This epidemic is going to get worse before it gets better. We have to
understand that the United States has, beyond a moral responsibility, a
political responsibility in terms of this HIV/AIDS epidemic. There was
a time a century ago when the problems around the world were in fact on
the other side of the world; they couldn't, frankly, make it to the
United States; many of these people who were sick would die on the way.
We now know that any problem on the other side of the world is a 10- or
12-hour airplane flight from being our problem.
Let us understand we cannot take the current course that is being
suggested by this administration. To give a symbolic amount of money
this year to the global AIDS effort is in fact to invite further
disaster on the people around the world and on the people of the United
States. To go, as the administration has said, along the route that
would suggest next year we would make no contribution to the global
AIDS fund suggests perhaps that they believe the epidemic is going to
wait for us to catch up with it. It won't. Then finally to say that
maybe 2 years from now we will put another $300 million in, that kind
of halfhearted, weak attempt to meet our moral and political obligation
will mean the AIDS epidemic will continue to grow, not just in Africa,
not just in Asia, but around the world.
Taking a meaningful, positive step forward in supporting prevention
of AIDS research and education is in the best interest of the United
States.
I note that major donor organizations such as the Gates Foundation
and the Kaiser Foundation and others have made a commitment to this.
The United States has to meet and exceed that commitment as well. We
have to make certain that the Senate reverses the sad, terrible vote we
cast just a few weeks ago, saying that we are not going to put more
money on an emergency basis to fight the AIDS epidemic. I hope my
colleagues in the Senate, as they reflect on the Barcelona conference
and the commitment of thousands of leaders around the world, the HIV/
AIDS epidemic, will put pressure on this administration to go beyond
the rhetoric, beyond juggling the books, about $500 million over a 3-
year period of time, and make a meaningful commitment that will save
lives.
I yield the floor.
The PRESIDING OFFICER. The Senator from Michigan is recognized.
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